Incidence and risk factors for recurrence of endocrinopathic laminitis in horses

Abstract

Background Endocrinopathic laminitis is common in horses and ponies, but the recurrence rate of the disease is poorly defined. Objectives To determine the incidence of, and risk factors for, the recurrence of endocrinopathic laminitis. Animals Privately owned horses and ponies with acute laminitis (n = 317, of which 276 cases with endocrinopathic laminitis were followed up to study completion). Methods This prospective cohort study collected data on veterinary‐diagnosed cases of acute laminitis for 2 years. Each case was classified on acceptance to the study as endocrinopathic or non‐endocrinopathic using data collected in a questionnaire completed by the animal's veterinarian. Follow‐up data were collected at regular intervals to determine whether the laminitis recurred in the 2‐year period after diagnosis. Results The recurrence rate for endocrinopathic laminitis was 34.1%. The risk of recurrence during the 2‐year study period increased with basal, fasted serum insulin concentration ( P ≤ .05), with the probability of recurrence increasing markedly as the insulin concentration increased beyond the normal range (0‐20 μIU/mL) to over the threshold for normal (up to approximately 45 μIU/mL). Being previously diagnosed with laminitis (before the study; P = .05) was also a risk factor for recurrent laminitis. Cases with a higher Obel grade of laminitis were likely ( P = .05) to recur sooner. Conclusions and clinical importance Knowing that hyperinsulinemia and being previously diagnosed with laminitis are significant risk factors for recurrence will enable clinicians to proactively address these factors, thereby potentially reducing the risk of recurrence of laminitis.

A Retrospective Study of Mortality Causes in Arabian Horses

“…Endocrinopathic laminitis is common in horses and ponies, but the recurrence rate of the disease is poorly defined. The recurrence rate for endocrinopathic laminitis was 34.1% (23).…”

The application of a new laminitis scoring method to model the rate and pattern of improvement from equine endocrinopathic laminitis in a clinical setting

“…Determining the reasons for slow improvement and/or recurrence is particularly important, as these are associated with a high euthanasia rate [1]. A recent survey indicated that factors such as a previous history of laminitis and the degree of insulin dysregulation are predictive of laminitis recurrence [22], and further detailed investigations are currently underway to determine the association of these and other factors with improvement rates. Our observation that weight shifting had a lower prevalence (64%) on the day of diagnosis than the locomotive criteria and digital pulse (98-100%), is similar to that seen in an earlier study [2].…”

Regenerative Medicine for Equine Musculoskeletal Diseases

“…Laminitis can occur due to any number of systemic or local insults and appear as an acute or chronic form [ 283 , 284 , 287 , 292 , 293 , 294 ]. The most common and known aetiologies for laminitis include endocrinopathies, sepsis/endotoxemia and overloading (supporting limb laminitis due to injury of the contralateral limb) [ 283 , 284 , 285 , 287 , 292 , 293 , 294 , 295 , 296 , 297 , 298 , 299 ].…”